Clean Your Thoughts Not Your Plate

I imagine that many people would have healthier relationships with their bodies and food if the message instilled at the family dinner table wasn’t, “You can leave the table when your plate is clean”.

We are often our own worst enemies when it comes to negative self talk.   Not only do we beat ourselves up mercilessly with thoughts like, “I’m fat, ugly, not smart enough”, we also have automatic thoughts, right below the level of consciousness that sabotage our efforts at weight loss, i.e., “I’m tired, I need some chocolate to make it through the meeting”, or “I don’t care; it won’t matter anyway”.   Some overweight adults still hear mom saying “Good girls clean their plate.”

In my first blog, I mentioned the three questions I encourage my clients to ask themselves repeatedly–what am I thinking, what am I feeling, and what is it I REALLY need right now?   Here’s how we use the tool at the Center for Thoughtful Weight Loss.  Yesterday, a weight loss client came in and said it was her husband’s birthday. I asked how they’ll celebrate, knowing special occasions have meant relapse in the past, not just extra calories for one meal.  “We’ve decided to have a healthy meal at home because it’s the best present we can give each other.  No need for wine or dessert.  It’ll be a simple delicious meal with some presents on the table.”  A big component of her success is planning ahead for situations that derailed her efforts in the past.  She has a two week training coming up out of town this summer for work.  Her plan is to bring an extra suitcase filled with healthy food choices.  She chose a hotel that is $30.00 extra per night, but has a full kitchen and a gym. Her intention is very clear– “Traveling and the stress of a two week business trip will not sabotage me.”.  While away, she’ll continue to talk with her diet buddy for support and problem-solving. She’ll schedule a phone therapy session with me to talk about grief issues that have sabotaged her for years, but only recently have been addressed without using food to numb out.

She brought in a surf board necklace (see last week’s blog about surfer dude) as a reminder to stay present so that she can catch her insidious sabotaging thoughts and correct them with self honoring, helpful thoughts.  In cognitive behavioral therapy we think about helpful vs harmful thoughts, behaviors, and social interactions. 

When we identify the sabotaging thoughts or what David Burns (author of the best selling self help book Feeling Good calls cognitive distortions), we have the opportunity to change our thoughts and self talk to accurate, realistic, and helpful thoughts, resulting in choices that
are in our best interests.

Here are some examples of sabotaging thoughts and helpful, accurate responses.  You can see which ones help people remain on plan and which lead to more eating to cover up feelings of sadness, worry, boredom, loneliness, anger, shame, and guilt.

  ST  (sabotaging thought): ” It’s okay to have cookies in the cabinet- they’re for treats.”
  HR ( helpful response):  “I need to accept that having unhealthy food choices around is testing myself beyond my ability to resist temptation.  It’s a mistreat not a treat the way I eat these cookies.”
  ST: ” I don’t have to track all my calories – it’s too time consuming”.
  HR:  “Not tracking keeps me from having consistent weight loss – it’s the # 1 tool of successful maintainers.”
  ST : ” Things are hard; I deserve  this double cheeseburger.”               
  HR :  “Things will  still be hard if I give in to this temptation.  Resisting will build up my confidence-I’ll call my friend, John; he’s a great listener, and I need some support and encouragement tonight.”

Sometimes we have to peel the layers of the onion to get to the thought that leads to the emotion that results in overeating.  Sometimes we need help figuring out what the hot thought is and what we need in that moment.

Feel free to email Ellen at Ellen@thoughtfulweightloss.com  if you’d like help figuring out What’s Eating You.

Ellen is a psychotherapist in private practice in San Francisco and Redwood City, California. She specializes in Cognitive Behavioral Therapy and incorporates the use of mindfulness into the treatment of depression, anxiety, and emotional overeating. She runs a holistic weight loss program called Center for Thoughtful Weight Loss, www.thoughtfulweightloss.com. You can email Ellen at ellen@thoughtfulweightloss.com.

Copyright © 2010 Ellen N. Resnick, LCSW

Ride the “Crave Wave”

A few months ago a weight loss client came in for a visit.  I couldn’t help but notice something odd looking falling out of her purse. I could only make out what looked to me like straw hair – it seemed like an odd doll for a mom of teen boys to be carrying around. 

My curiosity got the best of me and so I asked what it was.  Out came ‘surfer dude’.  “OMG, that’s amazing,” I said. “He is just perfect”. A few weeks earlier I had taught her Alan Marlatt’s concept of urge surfing, part of relapse prevention nomenclature for addictive behavior of any kind, including compulsive overeating.  If there is no opportunity to “use” Marlatt says, a craving typically lasts for less than thirty minutes.  If there is no opportunity to use, there is no inner struggle, and it’s the inner struggle that feeds the cravings. This is true for everyone, but few people give themselves the chance to prove it.

Ok, so where’s the surfer in this story?

Anyone who has struggled with food cravings knows that there are times that no matter what we do we to fight the cravings, we feel it’s just not possible to resist them.   It’s like trying to stop a waterfall from flowing.  Marlatt says, “Don’t try to stop the flow because you can’t.  Step back and become an observer of the waterfall, or your cravings, impulses, and urges for the peanut M and M’s.  Just watch the cravings come and go without judging yourself for having them.  Don’t berate yourself for your lack of willpower.  Simply use mindfulness (moment to moment, non-judgmental awareness) to experience your urges without giving in to them.  The urge may come very strongly, and still, you simply watch it, describe it to yourself in full detail, and let it go.  Some people think about sending the craving down the river on a bed of leaves.  Others send it off into a bubble in the sky. Still others send it on a conveyor belt and watch it go by.  It may come back; and when it does, simply put it back on the belt and watch it go round again.  Did it change the second time around?  Did you experience your urge exactly the same way or did it get more or less intense?  It doesn’t matter, as long as you are an observer without self judgment.  And if you notice yourself judging, simply say “judging” to yourself and put your judgments on the belt and watch them go by as well. The waterfall may feel like it’s going to come crashing down on you.  Out comes “surfer dude” who teaches you to ride the wave of the craving without getting caught in the undertow of emotions.   Our feelings can be strong sometimes just like food cravings, or urges for alcohol.  Get out “surfer dude”.  He or she will help you observe your emotions without going under. 

You can ride the crave wave!

Keep practicing.  Go out to the ocean and watch what the surfers do when they fall.

Ellen is a psychotherapist in private practice in San Francisco and Redwood City, California. She specializes in Cognitive Behavioral Therapy and incorporates the use of mindfulness into the treatment of depression, anxiety, and emotional overeating. She runs a holistic weight loss program called Center for Thoughtful Weight Loss, www.thoughtfulweightloss.com. You can email Ellen at ellen@thoughtfulweightloss.com.

Copyright © 2010 Ellen N. Resnick, LCSW

Ellen Resnick's Biography

I began working with people on behavior change in 1990 as a social
worker on a diabetes team at a prominent San Francisco hospital. It
became clear early on that managing one’s diabetes was directly
related to how people manage their lives and, in particular, their
stress. Often, I was seeing very bright people making very bad
choices. I soon became a student in Cognitive Behavioral therapy,
learning how people’s thoughts impacted their moods and behaviors,
including decisions about food, exercise, and managing stressful
situations.

My interest grew and I wrote a talk called “What’s Eating You: Learn
the Tools to Overcome Emotional Overeating”. The ideas seem to have
struck a chord with people. I began to treat depression, anxiety, and
relationship issues and voilà my clients were soon thinking clearer
and making better choices for their health–life affirming, self
honoring vs. self sabotaging and self defeating choices. They were
learning how to manage emotions without numbing out with food.
Fast forward to 2008. Although people were making better choices in
the moment, they didn’t have all the tools they needed to make good
decisions outside their comfort zone, i.e. when traveling, work
meetings (you know–when the large chocolate chip cookies appear after
the sandwiches big enough to feed a family of three), when they are
out with friends, celebrating, bored, lonely, procrastinating, at
their grandmother’s house, or with a ‘food pushing’ friend (“come on,
loosen up-it won’t matter this once.”). So, my next talk emerged:
“What’s Eating You: Ten Skills to Manage Stress and Enhance Well
Being”. People learned the importance of attitude–having hope that
this time they wouldn’t yo-yo because they’d have skills to handle
every situation with awareness of what they needed in that moment.
Soon, I was taking a picture of each of my clients. I’d ask them to
grab the hand that they eat with, leave the kitchen, take some calming
breaths and ask themselves three crucial questions: “What am I
thinking, what am I feeling, and what is it I REALLY need right now?”
Then came the job of building individual toolkits–things each person
could do if they were bored or sad or lonely, etc. My clients got
creative making pretty boxes and binders with ideas for self soothing.
Some chose knitting or jumping rope; others called their friends for
support as needed. The choices are endless IF you are mindful of what
you are needing and can slow your impulse to soothe with food down
long enough to make a self honoring choice. That is the work.
Fast forward to 2010 and I wrote two new talks: one adapted from
Judith Beck’s work that I call “What’s Eating You: Learn the Tools
for Permanent Weight Loss”, and the newest adapted from Susan Alber’s
work that I call “Eat, Drink and Be Mindful : Soothe Your Way to
Weight Loss”. The first talk teaches 42 cognitive and behavioral
skills for permanent weight loss. The second I now refer to as
“surfer dude”. Huh? Ok, surfer dude is about Marlatt’s concept of
‘surfing the urge’ which will be next week’s blog topic. Stay
tuned….


Ellen is a psychotherapist in private practice in San Francisco and
Redwood City, California. She specializes in Cognitive Behavioral
Therapy and incorporates the use of mindfulness into the treatment of
depression, anxiety, and emotional overeating. Her website
is www.ellenresnick.com She runs a holistic weight loss program
called Center for Thoughtful Weight Loss, www.thoughtfulweightloss.com. 
Ellen is also a skilled couples’ therapist.  She is an Assistant Clinical
Professor in the department of psychiatry at UCSF where she worked
from 1995-2003 specializing in women’s mental health issues and brief
treatment. She ran the Cognitive Behavioral therapy group program for
women with depression. Ellen continues to supervise psychiatry
residents at UCSF. She lectures extensively in the Bay Area. Feel
free to email Ellen at Ellen@thoughtfulweightloss.com